Date: Ship to:
Vendor:
Contact: Deliver to: _________________
Phone: Attention:
Ship Via: Extension:
Special instructions:
Qty Units Item # Description
Unit
Price
Total Account Code
Subtotal:
Sales/Comp Tax:
Shipping:
Misc. Charge:
Total Cost:
Ordered by: Date:
Staff Signature
Approved by: Date: ______
Principal Signature
General Fund Procurement-Card - Transaction Form